I want an Elective C-section- AIBU?

[MellaY]

Hi all, I'm wanting to know if you all think I'm a bit cracked and if anyone has advice on how to pursue this.

I will be a relatively young (21) first-time mum and also only 9 weeks pregnant. I have always had an unhappy relationship with parenthood and childbirth, which I have come to realise is much more about childbirth than the parenthood part and childbirth being a barrier to parenthood for me.

I have no desire to have a VB and the thought of it both terrifies and repulses me. This is for a variety of reasons:

When I was about 14 my cousin had a horrible experience of VB the first time where both she and her little boy nearly died, she also experienced a lot of tearing and has experienced discomfort ever since due to how she stitched up (there was some debate at the time whether she was stitched too tight and given the 'husband stitch'). The thought of this happening to me truly scares me.

When my mum had her first pregnancy and VB she needed emergency surgery during childbirth due to having a previously unknown vaginal septum.

I have a complicated medical history. I was very ill at the ages of 16/17 with a rare immune disorder known as adult-onset stills disease. This affected me profoundly partially due to the disease and partially due to the side effects of the medication I was on. I was in therapy throughout my illness and for a year after due its effects on me, I felt completely out of control of my body and what it was doing and how it looked (long term steroids). It was a very traumatic time for me. Despite me being well and unmedicated at this time I am being placed under consultant lead care and considered a high-risk pregnancy as there is little knowledge regarding how my illness may affect me and my pregnancy or whether pregnancy may cause it to flare up again. These complications may well lead to me needing a c-section anyway.

I struggle with an overactive bladder and have done for many years which I also fear will be worsened by childbirth to the point of negatively impacting my quality of life.

I cannot handle one more out of control thing happening to my body, I know I can't. I am fearful of what may happen during childbirth to both me and my child. I have had surgery in the past and have witnessed many surgeries (albeit on animals, not people) thanks to a job I had when I was younger. Surgery is a known factor to me, I know a c-section is not any easier than a VB but it is something I have already experienced and know I can cope with.
I am afraid of tearing which may sound vain or selfish to some but I know I wouldn't be able to cope with damage or scarring in that area of my body. It would destroy my self-esteem where I feel a scar from a c-section would not, it's a scar I have 'chosen' and not that I want it on my body that is simply more okay to me than tearing.

AIBU for wanting to pursue a C-section as the method by which I want to give birth considering all the reasons above? I feel like some will attribute it to my age without looking too much further past that. Also if anyone has any advice on how to broach this with practitioners or how they have dealt with similar issues your advice is welcome.

OP, you need to do the following:

1. request a consultant appointment to discuss your birth options. You don't need to explain the details to your midwife, she has no right to either approve or deny it
2. the most important thing when you talk to a consultant is to be confident. Write down beforehand your reasons for csection so you don't sound like a bit nervous first time mum. Also you need to tell them you fully understand all the associated risks. I recommend you do a proper research yourself before the consultant appointment so you know what you are talking about. You need to deliver the message across to show you are not 'considering csection because you are scarex/nervous of VB', but you are requesting one on the certain grounds you need to list.
3. once consultant approved your csection it is just a matter to get it scheduled. The scheduling process varies by hospital. Sometimes it will be scheduled after 20 weeks scan, sometimes you won't hear from them until 37th week

I always thought they were on medical grounds only, very interesting to read you can choose them as I can remember the whole 'to posh to push' scandal.

Every days a school day on mumsnet :-)

Just a side note the posters saying that you can request one - I’m not sure if this varies by area. I wanted a c section but kept being told no. Then I had a 17 hour labour and an emergency section. Sigh.

You have the right to request a c-section, and while your medical team may try to talk you out of it if they don’t think it’s best, they should still respect your wishes.

Advocating for your own prenatal healthcare can be hard because there are very established ways of doing things, but you sound very decisive and clear so raise it early with your midwife and stand firm in your choice.

Absolutely YANBU
You do not need to justify why- your body, your choice.
There will be some midwives that try to talk you out of it- don’t give in or even listen frankly. You can thank them but say you know what is right for you and your baby.
Have a look at the RCOG website
www.rcog.org.uk/
They have great information for patients on different kind of births and the possible complications and side effects of the choices out there. Arm yourself with the information, and ask to see a consultant if you like.
I had an EMCS in April - was great actually (decided that we would go with C sec at 36 hours post waters broken and no progress as I didn’t want to be a true emergency crash) I would go elective from the start second time around.

There is nothing vain about choosing a C sec for whatever reason. Don’t tell yourself that there is anything invalid about your motivations or your choice.

Congrats on your pregnancy and good luck!

YANBU. However, I would just like to say make sure you fully understand the risks associated with C-Sections. My C-Section left me with bladder issues so it’s no guarantee.

Thank you so much for all your responses.

I feel like I should have possibly mentioned in my initial post is I have a very weird relationship with scarring and have a rather complex mental health history. Aesthetically, scars to me are a non-issue. I do have a history of self-harm and have a variety of scars from that period in my life which I have never had any inclination to cover up nor do they bother me at all, especially considering I would have to dress like a bloody nun to cover the majority of them. My fears with a perineal tear or episiotomy would be less form and more long term function, I already have issues with urinary incontinence which are manageable but I have no desire to make this any worse than it needs to be. Another worry of mine is the potential it has for pain in a manner than would ruin my sex life and or cause sexual dysfunction.

@Iwonder08

OP, you need to do the following: 1) request a consultant appointment to discuss your birth options. You don't need to explain the details to your midwife, she has no right to either approve or deny it 2) the most important thing when you talk to a consultant is to be confident. Write down beforehand your reasons for csection so you don't sound like a bit nervous first time mum. Also you need to tell them you fully understand all the associated risks. I recommend you do a proper research yourself before the consultant appointment so you know what you are talking about. You need to deliver the message across to show you are not 'considering csection because you are scarex/nervous of VB', but you are requesting one on the certain grounds you need to list. 3) once consultant approved your csection it is just a matter to get it scheduled. The scheduling process varies by hospital. Sometimes it will be scheduled after 20 weeks scan, sometimes you won't hear from them until 37th week

Thank you that is some really clear advice, I already have an appointment to discuss complications related to my medical history as a precaution, would this be an appropriate place to also discuss a c section also in your opinion?

But you do realise there is also risk of bladder issues through c sections. I think your fear about sexual difunction is quite extream..not saying it can,t happen but for most thats not the case.

You can request a section for any reason.

I ended up with an EMCS after 17 hours of active labour and tbh the only reason I left it that long was because I was so scared of everything that came with a CS everyone will tell you their horror story’s and I was terrified but in all honesty I wish I had just done it when they originally suggested it 5hrs in tbh and I’m kicking myself because I put both myself and my DD through so much stress for nothing in the end.

Yes it’s painful and everyone is different but I was so surprised at how quickly I healed. The only thing is I would be mentally prepared to have to do it on your own as soon as you go back to the ward and by that I mean I had my dd in the middle of the pandemic last year. My OH got to spend an hour with us after in recovery but because of what was happening when we went to the ward that’s the last time I seen him for 5 days as we weren’t allowed any visitors at the time but tbh, I think it definitely helped get me back on my feet quicker because you don’t have any help and worked out totally fine but it was a shock at the time. Just in case things are still the same or similar when you have your baby but honestly I would go for it. If you have made your mind up then stick with it and if anyone try’s to tell you any horror story’s just tell them you don’t want to know.

Oh and congratulations and good luck for your pregnancy

I discussed having an ELCS with my midwife early on, she dismissed this and said “you can discuss birth options around 28 weeks”. I went to 28 week appt and explained my reasoning for wanting an ELCS - it was totally ignored (different midwife). I just did not feel listened to.

Baby was then breech for a number of weeks, up to 39 weeks - so THEN I had discussed and it was assumed I would be having a section.
DC then turned and went two weeks overdue - my anxiety built up so much I had a panic attack on the induction ward, said I could not go through with it, cue registrar telling me my baby was going to die if not delivered. Told them no induction thank you v much, they scheduled the section. It was absolutely the right decision for me.

If you know what you want then be prepared to be assertive from the beginning (sounds like you will be). I made the mistake of not speaking up loud enough and it added a lot of unnecessary anxiety to the end.
This is also dependant on the hospital/midwife team too from what I have heard from friends experiences/my second time.

YANBU. I've had a vaginal birth and an ELCS, which was to ensure less trauma as my first birth left me with incontinence issues. The ELCS was a dream and my incontinence situation continued to improve over time rather than getting worse. Go for it. All of the consultants I saw bar one were very supportive and recommended it. The final consultant I saw was obviously very anti CS. She booked me in begrudgingly but I'm so glad I stood my ground with her.

OP you might like my scar, it is sort of lopsided and looks like a onesided smile across my lower abdomen. It causes a smile in most people who see it. I assume that was because it was an emergency so a planned section might result in a tidier scar. My husband giving me a fit of the giggles that resulted in me bursting my stitches didn't help although it was quite satisfying to see him being escorted off the ward as the midwife tried to sort me out. You know what it is like when the more you try not to laugh the worse it gets, that's how I was and as I looked at the blood looking like a waterfall I didn't get serious at all. Childbirth is challenging isn't it.

I also have Adult Onset Stills though it has been in remission for many years.

I had an elective CS for my second child, mainly because of the way I was treated by medical staff in my first labour. I had no physical injuries. I totally emphasise with what you’re saying. You don’t have to justify yourself to anyone.

YANBU it’s your right to request a c section. I second writing your concerns down so that you don’t look like a nervous, first time mum. They could try to talk you in to a VB, so you will need to be very firm and stand your ground. Good luck.

@june2007

But you do realise there is also risk of bladder issues through c sections. I think your fear about sexual difunction is quite extream..not saying it can,t happen but for most thats not the case.

I truly can see where you're coming from r.e. bladder issues but from the information, I can find the risk is lesser but I won't pretend its non-existent. For me, that is one factor among many and I would rather have the ability to make a choice and live with the consequences of the choice. Fears aren't always rational, unfortunately, but for me that damage not happing and it not being a risk is very important.

I would just say my c section took a lot more recovery than my vbac. It was difficult to look after a new born after such major surgery.
I naively didn’t realise how much recovery is required after a c section and how scary it was.
I only say this because there’s every chance you could have a natural birth with appropriate maternal agency support.
I was petrified of a VB and with midwife support and therapy I actually looked forward to it

You don’t need to justify why you want one, just firmly request one of you’d like one. I felt very similar to you and I requested one and got it. It was amazing. So calm and I remember every moment and no pain. And the healing was fine, too. Don’t overthink it and don’t let anyone (in real life but especially on here) minimise your feelings. You don’t need to justify yourself.

Good luck.

You have the right. My c section left me infertile so that's always a risk

The thing about pregnancy and childbirth is that it makes you vulnerable; you can't have 100% control over it. You could hand over the removal of baby bit to someone else but that doesn't mean risk is removed. Get some proper advice (not Mumsnet which is very pro c section IMHO) and remember, you will hear more stories about nightmare v births than normal ones because people don't tend to talk as much about good experiences as they do about bad ones.

For a different perspective I've had 2 sections. Both were awful. I burst into tears when they told me I'd have to have another. Recovery was long, painful and as a pp has said I've a scar that is numb and itches many years after the fact.

The actual act of the section was hideous. I don't know how people said they felt in control. I never felt more out of control with a surgeon rummaging around inside and me being paralysed while child birth was done to me. Not to mention the indignity of the post section waddle to the toilet/shower on ward when you've only just got feeling back in your legs - gross. Hated it, hated it, hated it.

The first month of all of my babies lives was marred by pain, limited ability to move, and fear of tearing myself open, and my sections were as complication free as you can get. I would never recommend a C-section as a choice.

You are not unreasonable but neither are C- sections a risk-free option.

You need to inform yourself fully of the risks and, if it's still your choice, be prepared to dig your heals in and shout from the rooftops until you get what you want.

The NHS promotes one particular type of birth for ideological reasons and because it's cheap ("natural", limited pain relief, no epidural). As the maternity scandals of the past few years have shown, they're terrible at listening to women about their wishes and what's going on with their bodies. So be prepared to be your own advocate and don't let them fob you off.

Go for it! I'm sorry I didn't. I had a horrendous birth with my first and I don't think I'm truly over it five years later. My second was the text-book perfect vaginal birth and I must say it was an exhilarating experience but I imagine that was mostly because the first time everything went wrong and I was just so relieved the second one didn't. It's just all so uncertain childbirth. If I had my time again I would request an elective without a doubt.

Congrats on you pregnancy!

Youre not unreasonable for wanting a c section. I think there is a section in the NICE guidelines about elective sections. May be worth having a read through. You may have to fight for it, but its absolutely your right. Show them that you understands there's still risks but those risks are more acceptable to you. Good luck